# A Comparison of Flow Cytometry-based versus ImmunoSpot- or Supernatant-based Detection of SARS-CoV-2 Spike-specific Memory B Cells in Peripheral Blood

## TL;DR

This study compares three methods for detecting SARS-CoV-2-specific memory B cells in blood and finds they all work well, with ImmunoSpot showing better sensitivity.

## Contribution

The first direct comparison of three B cell detection methods using the same samples in a blinded setup.

## Key findings

- All three assays can distinguish Spike-exposed individuals from naïve controls.
- ImmunoSpot shows higher sensitivity and specificity compared to the other methods.
- ImmunoSpot and flow cytometry results are closely correlated.

## Abstract

Background: Memory B cells (Bmem) facilitate the generation of renewed and rapid antigen-specific antibody responses long after the initial antigen exposure, at a time when circulating serum antibodies may have declined. As the generation and/or recruitment of Bmem is at the core of most vaccination strategies, the assessment of antigen-specific Bmem is highly informative for forecasting and profiling the elicited B cell immune response. Methods: The two prevalent techniques used to detect antigen-specific Bmem cells at single-cell resolution are probe-based flow cytometry and B cell ImmunoSpot, while the measurement of B cell-derived antibodies in culture supernatants of stimulated B cells offers a semi-quantitative alternative. To the best of our knowledge, a direct side-by-side comparison of these assay systems has not yet been reported using the same starting PBMC material in a blinded fashion to test all three assays simultaneously. Results: These three assay systems were run in parallel to detect SARS-CoV-2 Wuhan-1 strain Spike-specific IgG+ Bmem in peripheral blood mononuclear cell (PBMC) samples obtained from well-defined cohorts comprising pre-COVID-19 era “naïve” individuals (negative controls), individuals shortly after recovery from a PCR-verified SARS-CoV-2 infection (positive controls), and a cohort of donor PBMCs isolated in 2024 (the experimental group). Each assay was able to discern Spike-exposed individuals from naïve , with ImmunoSpot suggesting superior sensitivity and specificity. ImmunoSpot and flow cytometry results were closely correlated. Conclusions: The study demonstrates that all three assays are suited for the detection of specific Bmem in antigen-primed individuals when such Bmem occur in the mid- to high-frequency range, and that they broadly concur. Strengths and weaknesses of the three test systems are discussed.